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General NPI Number Information
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NPI Number | 1346552312
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Entity Type | Organization
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Legal Business Name | BAYLOR COLLEGE OF MEDICINE
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Dates
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Enumeration Date | 07/07/2010
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Last Update Date | 07/19/2011
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Provider Practice Location Address
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Address Line | 1977 BUTLER BOULEVARD E1.108
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City | HOUSTON
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State | TX
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Zip | 77030-4202
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Country | US
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Telephone | 713-798-2020
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Fax | 713-798-2025
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Provider Business Mailing Address
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Address Line | 2 GREENWAY PLZ SUIT E900
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City | HOUSTON
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State | TX
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Zip | 77046-0297
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Country | US
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Telephone | 713-798-1750
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Fax | 713-798-1144
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Authorized Official
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Title or Position | COO
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Name | MR. JOHN R NICKENS
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Credential |
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Telephone | 713-798-1750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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